2/13/17 DURRANT Skin and soft TIssue infection TEST #2 Flashcards
What is the first line of defense for soft tissue infections?
-Intact skin (physical barrier)
_____ of skin structures permit microbial invasion?
-Ducts
T/F Trauma can also permit microbial invasion.
-True
What are the four medical terms that are used to describe soft tissue infections?
- Rubor
- Calor
- Tumor
- Dolor
What are five things you might see on a physical examination of a soft tissue infection?
- Crepitus
- Necrosis
- Fluctuance
- Purpura
- Bullae
What are six other disease that can mimic Skin and Soft tissue infections?
- Gout
- Thrombophlebitis
- Deep vein thrombosis
- Contact dermatitis (example latex allergy)
- Drug eruption
- Foreign body reaction
What is the number one bacteria that causes folliculitis?
-Staph aureus
What organism causes hot tub folliculitis?
-Pseudomonas aerguinosa
What is the basic treatment for folliculitis?
- Soap and water
- Topical antibiotics
What is a common cause of acne?
-Propionibacterium acnes
T/F Staph aureus can cause acne
True
Where does propionbacterium acnes multiply in?
-Sebum trapped in follicles/glands
What is the most common cause of soft tissue abscesses?
-Staph aureus
When you have a soft tissue abscess what causes local superficial cellulitis?
Bacteria
When you have necrose/liquefy tissue in a soft tissue abscess what does that consist of?
- Cellular debris
- WBCs (pus)
What do you do to treat soft tissue abscesses?
- Incision and drainage
- Systemic antibiotics
T/F Soft tissue abscesses are often polymicrobial
True
What is an abscess in the area of a hair follicle also known as a boil?
-Furuncle
What is a multiloculated abscess?
-Carbuncle
When you have a carbuncle where can the infection spread to?
-Subcutaneous tissue
What is the treatment of a carbuncle?
- Incision
- Drainage
What is the disease of an enzyme producing bacteria that digest fascial barrier, and cause tissue necrosis?
-Necrotizing fasciitis
What is the main cause of necrotizing fasciitis?
-Group A strep
T/F Only gram + bacilli create spores
True
What is a polymicrobial infection of the genitals and perineum called?
-Fournier’s gangrene
What is the hallmark finding of necrotizing fasciitis?
-Huge amount of pain compared to exam findings
What is the most common pathogen found in surgical wounds?
-Staph aureus
What is the gram stain of staph aureus?
-Gram + cocci in clusters
What are three sources of surgical wounds pathogens?
- Patients own skin/normal flora
- Fomites (door handle, drinking fountain etc.)
- Hands
- Air
- Environment
What is the best way to keep surgical wounds from becoming infected?
-Preoperative antibiotics
When you have fungal infections what is the most common one seen?
-Dermatophyte fungi (superficial hair, skin, and nail infections)
What is the most common yeast infection?
-Candida albicans
What do you do to treat Candida albicans?
- Topical antifungals
- Systemic antifungals if severe
What three things can candida albicans cause?
- Diaper rash
- Thrush
- Intertrigo
Is impetigo highly contagious?
-Yes
How do you treat impetigo?
- Penicillin
- Topical antibiotic
What is a honey crust lesion known as?
-Impetigo
What are the top two causes of Impetigo?
- Group A strep
- Staph aureus
What is a painful red looking disease that is hot to the touch and found in the deep layers of dermis?
Erysipelas
What causes Erysipelas?
-Group A strep
What is the treatment for Erysipelas?
-Penicilin
What is a painful red looking disease that is found in the subcutaneous tissue?
-Cellulitis
What is the main cause of Cellulitis?
-Group A strep
What is the treatment of cellulitis?
-Systemic antibiotics
T/F If you have a higher number of organisms it increases your risk of wound infections
True
If you have a lower number of virulence organisms is will increase your risk of wound infections
False
-A higher number of virulence
What is the “all time champion” of microbial pathogens
Staph aureus
T/F You usually see a lot of pus if it is a staph aureus infection
True
What type of lesions does staphyaureus cause?
- Acute
- Aggressive
- Locally destructive purulent
What type of Staph toxin causes scalded skin syndrome?
-Alpha-toxin (exotoxin)
What type of staph toxin causes bullous impetigo?
-Exfoliatin
What type of Staph toxin causes Toxic shock syndrome?
-TSST-1
What type of Staph toxin causes stphylococcal food poisoning?
-Enterotoxin (Exotoxin that effects the gut)
What gene do MRSA strains acquire?
-MecA gene (altered penicillin binding protein)
MSSA or MRSA is resistant to all B-lactams?
-MRSA
What are four risk factors for MRSA?
- Close skin to skin contact
- Crowded living conditions
- Poor hygiene
- IV drug users
What are five antibiotics that you can use to treat MRSA?
- Trimethoprim-sulfa
- Doxycycline
- Vancomycin
- Linezolid
- Daptomycin
What does a Group A strep look like?
-Gram + cocci in chains
Streptolysins O and S are cytotoxic or non-cytotoxic?
-Cytotoxic
T/F Streptolysins O and S lyse leukocytes, tissue cells, and platelets
True
What type of strep toxins are superantigens?
-Pyrogenic exotoxins A and B
What are three inflammatory enzymes produced by group A strep?
- Streptokinase (protease)
- Hyaluronidase (degrades carbohydrates)
- DNase (degrades DNA)
What is an anaerobic spore forming gram+ rod with square ends?
-Clostridium perfringens
What type of gas does Clostridium perfringens produce in tissue?
- Hydrogen
- CO2
What type of gram stain is Pasteurella multocida?
-Gram - Rod
What causes Pasteurella multocida?
-Animal bites
What type of gram stain is Pseudomonas aeruginosa?
-Gram - Rod
What type of gram stain is Vibrio vulnificus?
-Gram - Rod
Where do you find Vibrio Vulnificus?
-Salt walter environments
What is Vibrio vulnificus associated with?
- Iron overload
- Cirrhosis
What causes Mycetoma?
- Actinomycyes
- Nocardia
